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Study shows self-use bulb syringe earwax treatment could save NHS time

RCGP (The Royal College Of General Practitioners) : 19 December, 2007  (New Product)
A new study funded by the Royal College of General Practitioners (RCGP) has indicated that a self-use bulb syringe can be an effective first-line treatment for earwax.
The inexpensive syringe, available over the counter in the US and in most European countries, could reduce the need for ear syringing in primary care.

The study, which has been published in the British Journal of General Practice (BJGP), used an open, randomised and controlled trial in seven practices in Hampshire.

The 237 patients with symptomatic occluding earwax were divided into two groups. The first group was given ear drops, a bulb syringe, and instructions on its use. The other received ear drops, followed by ear irrigation by the GP or practice nurse. The main outcome measures were symptoms (on a 7-point scale), wax clearance, need for further treatment, and the acceptability of treatment.

Comparing patients that used the bulb syringe with conventional irrigation, the change in the mean symptom score was -0.81 and -1.26 respectively, and regarding the proportion that needed no further irrigation, 51percent and 69 percent respectively. Although irrigation was preferred by more patients, most patients using the bulb syringe would use it again (75 percent versus 100 percent) and were satisfied with treatment (71 percent versus 99 percent).

Dr Richard Coppin, who headed the trial, said, “This study shows that although first-line treatment by irrigation carried out by a practice nurse is more effective, a third of those patients will probably have to return a second time for further irrigation. This compares with half of patients using a bulb syringe. Based on these rates, a policy of offering bulbs as an initial alternative to nurse irrigation would result in a worthwhile reduction in the number of irrigations performed.

“A potential impediment to the implementation of this in the UK is the current limited availability of bulb syringes. However, there is no reason why pharmacies and practices should not be able to order stocks of bulbs for their patients to use.”

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